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Keeping children safe at home: protocol for a matched case-control study of modifiable risk factors for poisoning
  1. Gosia Majsak-Newman1,
  2. Penny Benford2,
  3. Joanne Ablewhite2,
  4. Rose Clacy2,
  5. Frank Coffey3,
  6. Nicola Cooper4,
  7. Carol Coupland2,
  8. Mike Hayes5,
  9. Bryony Kay6,
  10. Elaine McColl7,
  11. Richard Reading1,
  12. Alex Sutton4,
  13. Jane Stewart8,
  14. Michael Craig Watson8,
  15. Denise Kendrick2
  1. 1Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
  2. 2Division of Primary Care, School of Medicine, Nottingham, UK
  3. 3DREEAM (Department of Research and Education in Emergency medicine Acute medicine and Major trauma), Nottingham University Hospitals' NHS Trust, UK
  4. 4Department of Health Sciences, University of Leicester, Leicester, UK
  5. 5Child Accident Prevention Trust, London, UK
  6. 6Emergency Department, United Bristol Healthcare Trust, Bristol Royal Infirmary, Bristol, UK
  7. 7Newcastle Clinical Trials Unit, The Medical School, Newcastle University, Newcastle upon Tyne, UK
  8. 8School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
  1. Correspondence to Gosia Majsak-Newman, Clinical Research & Trials Unit, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich NR4 7UY, UK; gosia.majsak-newman{at}nnuh.nhs.uk

Abstract

Background Childhood unintentional and suspected poisonings are a serious public health problem. Evidence from systematic reviews demonstrates that home safety education in combination with safety equipment provision increases the safe storage of medicines and other products. There is lack of evidence that poisoning prevention practices reduce poisoning rates.

Objectives To estimate ORs for medically attended poisonings in children aged 0–4 years for items of safety equipment, home hazards and parental safety practices aimed at preventing poisoning, and to explore differential effects by child and family factors.

Design Multicentre case-control study in UK hospitals with validation of parent-reported exposures using home observations. Cases are aged 0–4 years with a medically attended poisoning occurring at home, matched on age and sex with community controls. Children attending hospital for other types of injury will serve as unmatched hospital controls. Matched analyses will use conditional logistic regression; unmatched analyses will use unconditional logistic regression to adjust for confounding variables. The study requires 266 poisoning cases and 1064 matched controls to detect an OR of 0.64 for safe storage of medicinal products and of 0.65 for non-medicinal products, with 80% power, a 5% significance level and a correlation between exposures in cases and controls of 0.1.

Main outcome measures Unintentional childhood poisoning.

Discussion This will be the largest study to date exploring modifiable risk factors for poisoning in young children. Findings will inform: policy makers developing poison prevention strategies, practitioners delivering poison prevention interventions, parents to reduce the risk of poisoning in their homes.

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